Verbal update on the ongoing changes to the Integrated Care Board (ICB) landscape.
Contact: Vicky Dutchburn, Accountable Officer, NHS, West Yorkshire ICB, Kirklees Place.
Minutes:
Vicky Dutchburn, Interim Accountable Officer for the Kirklees Integrated Care Board (ICB), provided an update to the Health and Wellbeing Board on recent developments within the ICB landscape. The Board was advised that at the end of March 2025, notification was received from the Department of Health and Social Care NHS England, indicating that there would need to be a 50% reduction in the workforce. This reduction would apply to ICBs operating both at the local (place) level and across the West Yorkshire regional level.
A deadline was set to achieve this reduction by Quarter 3 of this current financial year, which necessitated a rapid and significant pace to reduce the workforce by 50%. The reduction would apply not only to staffing levels but also to overall running costs.
The Board was informed that since April, work is being undertaken to respond to the notification. It was acknowledged that this will be a challenging process, requiring significant effort to meet the targets set by Quarter 3.
Referring to the presentation, the Board was provided with an updated position on the work undertaken to date, and the work that is ongoing. The information presented outlined the proposed future structure of the health and care system.
The structure would include:
Strength is being built into the blueprints for future provider alliances and collaborations.
It was highlighted that there are four key elements to this, and while these components are being undertaken in isolation and progressing on different timescales, they are all interdependent on each other to move forward. For example, the national and regional teams have been advised that their changes will not be in place until 2027.
The Board was informed that the core ICB is transitioning towards a
Strategic Commissioner model. As part of this shift, many service
delivery functions will either be transferred to other
organisations or be discontinued. The Strategic Commissioner will
focus on work already being undertaken in partnership, with an
emphasis on understanding the local context, developing long-term
plans, commissioning services through appropriate partners to
deliver the strategy, evaluating impact, and maintaining a
continuous improvement cycle.
With regard to future roles emerging from the strategic blueprint released in June, partners across West Yorkshire have reviewed and interpreted the blueprint and made some assumptions. This has informed the identification of key functions and roles required to support delivery, ensuring alignment with regional priorities and the evolving commissioning landscape.
Future roles for the ICB:
- The ICB will be the strategic commissioner for West Yorkshire, convenor of the Integrated Care System, and integrator of providers and services:
- Strategic commissioner – the ICB will ensure that services are planned and delivered in a way that meets the needs of the population both now and in the future. It involves a systematic approach to defining and measuring outcomes, using data and intelligence to make informed decisions about resource allocation and service delivery.
- Convenor - the ICB will bring together all partners in the Integrated Care System to agree and deliver its five-year strategy and ensure delivery of local and national priorities by working together effectively and taking mutual responsibility for the results. It will co-ordinate the governance of the partnership and its wider arrangements for collaboration, within a framework of distributed leadership.
- Integrator – Place-based integrator teams will assess population health risk and facilitate place provider partnerships to co-design new integrated models of care. This function will deliver a small proportion of services, which will align to integrated neighbourhood teams and the primary care work.
The Board was informed that staffing levels currently stands at approximately 120 whole-time equivalent posts. However, when viewed in the context of the emerging place-based model, this represents a significant reduction in workforce capacity. Therefore, there is a need to carefully manage this transition to ensure that place-level responsibilities are adequately resourced and supported.
The Board was provided with an overview of the emerging Strategic Commissioning, Convenor, and Integrator functions at the West Yorkshire level. Strategic commissioning will operate at the West Yorkshire level, undertaking high-level needs assessments, setting regional priorities, and managing contracts with major providers. These outputs will be cascaded to place-level integrator functions, which will use local insight to shape neighbourhood-level service delivery, align partnerships, and support the shift from hospital-based care to community-based solutions. The integrator role will also support the development of digital infrastructure and contribute to the wider 10-year transformation plan.
The Board received a summary outlining the current status and future transition of several key functions, including APR management, the primary care workforce, continuing healthcare, and research. These functions are currently part of the ICB, however, are expected to transition to the provider arm over the next two years. This creates uncertainty for affected staff, who face both immediate workforce reductions and the prospect of further organisational change.
The Board was informed that concerns have been raised regarding the lack of national guidance, especially in relation to continuing healthcare. Despite expectations that the guidance would be issued by the end of June, it has yet to be published, creating a risk that current plans may need to be significantly revised. The planning has had to proceed based on assumptions and "known unknowns," it will be important to monitor developments closely to ensure flexibility in response to any future national directives.
The Board was provided with contextual information regarding the scale and impact of workforce changes across the West Yorkshire region. Currently, there are approximately 1,600 staff within the ICB, projections indicate a reduction to approximately 600 staff as functions begin transitioning out over the next two years. The final ICB workforce could be approximately 300–340 staff, with only around 125 whole-time equivalents allocated to place-facing roles. This significant reduction highlights the need for careful workforce planning and support during the transition.
The Board was updated on the significant organisational changes underway across West Yorkshire, including the development of new governance structures in preparation for formal consultation. Initial plans, aim for consultation to begin in July to meet national deadlines for workforce reductions in Q3. However, due to delays outside of local control, particularly the absence of national and regional blueprints, the timeline has slipped, with consultation now tentatively planned for September. A final decision on whether to proceed with consultation in September will be made next week, depending on whether the required blueprints and assurances are received.
The Board was informed that, should consultation proceed in September, staff will be presented with proposed structures for all functions across West Yorkshire and at place, including evaluated job descriptions. This work has been completed and is ready for release, providing transparency and clarity for staff. The consultation will only proceed if there is sufficient assurance that national and regional blueprints are in place to support meaningful engagement. Any significant changes to those blueprints that affect the integrity of the proposed structures may result in a pause and redesign of elements, particularly where national frameworks such as for continuing healthcare are still outstanding.
West Yorkshire has entered phase two of its transition planning, which includes engagement with staff and partners around the three proposed delivery pillars. Scenario development is underway to explore how these pillars might operate in an integrated system. A West Yorkshire-level transitional Board has been established and meets monthly to oversee partnership arrangements and ensure strategic alignment. This governance structure is intended to support a smooth transition and maintain oversight during a period of significant organisational change.
Status of the plan:
• A proposed future structure was submitted to NHSE on 30 May
• A brief meeting was held with regional colleagues on 10 June, during which clarification was provided on specific aspects of the transition plan.
• A national moderation of ICB plans took place on 9 June. As of yet, no formal or specific feedback has been received regarding the submitted plan.
• National FAQs on Implementing the Model ICB were issued on 23 July. The plan is consistent with the guidance provided in the responses to the FAQs.
• Informal guidance provided to ICB Directors of Finance by national colleagues, indicates that the assumptions made regarding all functions being included within the £19 per head funding allocation are considered appropriate.
• Intention to consult on new structures commencing 3rd September.
The proposed staff consultation, is planned to begin on 3rd September and staff have been informed of this timeline but also made aware of the risk that it may be delayed due to factors beyond local control. This uncertainty has been challenging for staff, who have been preparing for significant workforce reductions throughout the year. The delays are linked to the absence of national and regional blueprints, which are essential for providing the necessary context and assurance for meaningful consultation. This is a national issue, not specific to West Yorkshire or Kirklees.
To support staff during this period, regular engagement has been prioritised. West Yorkshire-level staff briefings are held fortnightly, alongside Kirklees specific sessions that offer space for questions, challenges, and clarification. Monthly meetings also continue to focus on business-as-usual activity, helping maintain motivation and momentum across ongoing programmes such as integrated neighbourhood teams.
In response to the information presented, the Board made comments and asked a number of questions including some of the following:-
- Acknowledging the fluidity of the situation can further updates be provided as information becomes available.
- Board members are supportive of colleagues across the ICB, and recognise the pressure they are under and also the work being undertaken.
- There are a couple of statutory risks which are not to do with the local ICB but with the national arrangements. The statutory responsibility for SEND, and the statutory responsibility for children safeguarding are unclear, and that has happened at a time where there is significant reform in children's services through the Children Family and Schools Bill. It is important to assure the Board, that this is being monitored and it is being raised by the Directors of Children’s Social Services at a national level.
- The Board acknowledged that partnership working is well established, supported by arrangements that enable constructive collaboration. It was noted that maintaining this way of working remains important, regardless of any future structural changes.
RESOLVED:
That:
a) Vicky Dutchburn be thanked for providing an update on the changes to the Integrated Care Board landscape.
b) The Board continues to be kept informed through regular and timely updates.